人工气道并发症发生原因及护理

危重病人抢救治疗过程中，保持呼吸道通畅，维持有效通气换气功能，是争取救治时间的首要环节。因此，建立有效的人工气道，保证有效通气，同时防止并发症的发生，显得尤为重要。我们从2002年开始至今，对建立人工气道的73例病例，实行了并发症原因的分析，并采取了相应的预防措施和护理，收到了满意效果，现将护理报告如下。     

Molecular diagnostics of genetic eye diseases

Eye diseases can be simple or complex, and mostly of heterogeneous molecular genetics. Some eye diseases are caused by mutations in a single gene, but some diseases, such as primary open angle glaucoma, can be due to sequence variations in multiple genes. In some diseases, both genetic and epigenetic mechanisms are involved, as was recently revealed in the mechanism of retinoblastoma. Disease causative mutations and phenotypes may vary by ethnicity and geography. To date, more than a hundred candidate genes for eye diseases are known, although less than 20 have definite disease-causing mutations. The three common genetic eye diseases, primary open angle glaucoma, age-related macular degeneration, and retinitis pigmentosa, all have known gene mutations, but these account for only a portion of the patients. While the search for eye disease genes and mutations still goes on, known mutations have been utilized for diagnosis. Genetic markers for pre-symptomatic and pre-natal diagnosis are available for specific diseases such as primary open angle glaucoma and retinoblastoma. This paper reviews the molecular basis of common genetic eye diseases and the available genetic markers for clinical diagnosis. Difficulties and challenges in molecular investigation of some eye diseases are discussed. Establishment of ethnic-specific disease databases that contain both clinical and genetic information for identification of genetic markers with diagnostic, prognostic, or pharmacological value is strongly advocated.     

Effect of heparin on production of basic fibroblast growth factor and transforming growth factor-beta1 by human normal skin and hyperplastic scar fibroblasts.

Heparin affects both dermal fibroblast proliferation and collagen and may mediate these effects by altering the levels of basic fibroblast growth factor (bFGF) and transforming growth factor-beta1 (TGF-beta1) production as a wound healing modulator. The purpose of this study is to probe the effect of heparin on bFGF and TGF-beta1 production by human normal skin and hyperplastic scar fibroblasts. This research investigates the effect of heparin on bFGF and TGF-beta1 production by human normal skin and hyperplastic scar fibroblasts with exposure to 0, 100, 300, or 600 microg/ml heparin for 24, 48, 72, or 96 hours in a serum-free in vitro model. Levels of bFGF and TGF-beta1 in the supernatants were determined by enzyme-linked immunosorbant assay. All doses of heparin significantly stimulated production of bFGF by normal skin (393% to 1019% increase) and hyperplastic scar fibroblasts (405% to 899% increase) at all time points (P < .05). Heparin (300 and 600 microg/ml) also stimulated TGF-beta1 production by normal skin (26% to 83%) and hyperplastic scar fibroblasts (63% to 85%) with statistical significance (P < .05) at various time points. These effects of heparin on normal skin and hyperplastic scar fibroblasts may have implications for hyperplastic scar formation and wound healing in vivo.     

Phytotoxicity of Thiocyanate to Rice Seedlings

The acute toxicity of potassium thiocyanate (KSCN) and ammonium thiocyanate (NH₄SCN) to rice seedlings was tested. Hydroponically-grown plants showed different responses to the two species of thiocyanate. NH₄SCN caused more severe stress to rice seedlings than KSCN. A significant reduction in transpiration and relative growth was observed with all NH₄SCN treatments (p < 0.01), while the effect of KSCN on rice seedlings was more evident at greater than 100 mg SCN/L (p < 0.01). Both chemicals had a negligible effect on total chlorophyll content in shoots of rice seedlings (p > 0.05). Although phyto-transport of thiocyanate was apparent, rice seedlings showed significantly higher removal potential for NH₄SCN than KSCN.     

Clinicopathological characteristics and surgical outcomes of divided nevus of the eyelids: a decade's experience on 73 cases

Currently, there is a lack of comprehensive data regarding clinicopathologic characteristics and surgical treatment of divided nevus of the eyelids. Here clinicopathologic features and reconstructive procedures performed on 73 patients were described. We showed that the lesion was randomly located on both eyes with a predominant incidence in females. Affected regions included the following: eyelid only (n = 40, 54.8%); medial canthus involvement (n = 4, 5.5%); medial canthus, caruncle, and bulbar conjunctiva involvement (n = 5, 6.8%); lateral canthus involvement (n = 18, 24.7%); full eyelids (n = 6, 8.2%); and cheek extension (n = 9, 12.3%). Lesions presented as a pigmented macule (n = 18, 24.7%) or mass (n = 55, 75.3%). Ptosis was present in 26 (35.6%) cases leading to visual field defects (n = 9, 12.3%). The puncta were covered in 13 (17.8%) cases. Overall, surgical results were satisfactory. Pathologically, lesions were either intradermal (n = 40, 54.8%), junctional (n = 15, 20.5%), or compound (n = 18, 24.7%). Because of the lack of systemic data regarding the rare entity of divided nevus of the eyelids, this study improves our understanding of this lesion, and it should be treated with individualized reconstructive procedures. Incorporation of pediatric patient population in the future will further extend our knowledge in dealing with this disorder.     

Primary renal neuroblastoma--a clinical pathologic study of 8 cases

Neuroblastoma is the most common extracranial solid tumor to occur during infancy and early childhood. However, primary renal neuroblastoma is rare, and only scattered case reports exist in the English medical literature. We report 8 cases that accumulated at our institution over the past 15 years and summarize their clinicopathologic features. The composite picture of a patient with renal neuroblastoma is that of a boy of 17 months of age, who presented with a large renal mass, about 9 cm in size, accompanied by hypertension. The mass was typically hemorrhagic, either encapsulated or unencapsuated, and infiltrating. A renal neuroblastoma can be undifferentiated, poorly differentiated, or differentiating; it falls into either the favorable or the unfavorable histology category, and presentation at higher stages is the rule. The N-myc is usually unamplified, and the bone marrow is usually not involved at presentation. Unless the tumor is undifferentiated or very poorly differentiated, patients with renal neuroblastoma fare well, although not without new and improved modalities of treatment. Primary renal neuroblastoma is perhaps more common than people realize; a higher level of awareness and early recognition are important for its prognosis and management, as they are very different from Wilms tumor.     

Accumulation and phytotoxicity of microcystin-LR in rice (Oryza sativa)

Irrigation with eutrophic water containing microcystins-LR (MC-LR) poses a potential risk to crops. However, the accumulation of MC-LR in rice grains and the mechanism of MC-LR-induced inhibition in rice roots are not understood. In this study, we detected the accumulation of MC-LR in rice grains collected from Taihu Lake region. MC-LR could accumulate in rice grains, but the risk evaluation suggested that MC-LR levels in rice grains from Taihu Lake region may not pose a threat to human health currently. In addition, MC-LR with low concentrations did not affect the growth of rice roots. However, MC-LR with high concentrations impeded the rice root morphogenesis by inhibiting root elongation, crown root formation, and lateral root development from primordia. Treatment with high concentrations of MC-LR stimulated the production of reactive oxygen species (ROS) and inhibited the production of nitric oxide (NO) in rice roots. Exogenous NO treatment reversed the inhibition of rice root growth under MC-LR stress. These results indicated that ROS and NO played important roles in the development of rice roots in responding to MC-LR stress.